High Risk of Obstructive Sleep Apnea in Commercial Drivers

About 40% of commercial drivers may have obstructive sleep apnea, suggests a research review in the June Journal of Occupational and Environmental Medicine.
Paul D. Blanc, MD, MSPH, of University of California San Francisco and colleagues reviewed and analyzed previous studies of occupation as a risk factor for OSA. All studies used sleep laboratory testing (polysomnography, or PSG) to diagnose OSA.
Analysis of pooled data from 16 studies suggested that 41% of commercial drivers may have OSA—nearly twice as high as for non-obese men in the general population.
Further analysis of a select group of studies estimated a 35% rate of mild OSA in commercial drivers and a 12% rate of moderate to severe OSA.
Data from eight studies suggested a possible increase in OSA risk among workers exposed to solvents—although this risk could not be statistically confirmed. A handful of other studies suggested possible increases in OSA among railroad workers, shift workers, and World Trade Center disaster responders.

Obstructive sleep apnea is a common condition, but little is known about possible occupational factors associated with it. The researchers suggest that commercial drivers may have other OSA risk factors, including stress, high rates of obesity and high blood pressure, and abnormal sleep/wake schedules.
Regardless of the other factors involved, daytime sleepiness and other OSA symptoms may be associated with an increased risk of accidents.
Further studies are needed to clarify possible occupational associations with OSA.
Dr. Blanc and colleagues conclude, “Pending more definitive data, clinicians should take into account occupational factors in considering sleep disorders and OSA, which carry significant associated costs from comorbidities and occupational disability.”

Feds Withdraw Rulemaking Notice 

The Federal Motor Carrier Safety Administration and the Federal Railroad Administration on Aug. 4 withdrew a March 10, 2016, advance notice of proposed rulemaking concerning the prevalence of moderate-to-severe obstructive sleep apnea among individuals occupying safety sensitive positions in highway and rail transportation, and its potential consequences for the safety of highway and rail transportation.
The agencies say that current safety programs and FRA’s rulemaking addressing fatigue risk management are the appropriate avenues to address OSA.